Ohio Admin. Code 5123-7-23 - Intermediate care facilities for individuals with intellectual disabilities - method for establishing the other protected costs component of the prospective rate

Current through all regulations passed and filed through December 3, 2021

(A) Purpose

This rule sets forth the method for establishing the other protected costs component of the prospective rate paid to an intermediate care facility for individuals with intellectual disabilities (ICFIID).

(B) Calculation of per diem rate

Each eligible ICFIID shall be paid a per diem for each resident for other protected costs. This component of the rate will be established prospectively each fiscal year. This per diem shall be calculated by dividing the desk-reviewed, actual, allowable other protected costs total except for the franchise permit fee (account number 6091) by the inpatient days. This information will come from the year-end cost report preceding the fiscal year in which the rate will be paid. This per diem will then be inflated by the estimated inflation rate as calculated in accordance with paragraph (C) of this rule and added to the per diem for the franchise permit fee as calculated in accordance with paragraph (D) of this rule to determine the total other protected costs component of the prospective rate.

(C) Estimated inflation rate

The department shall estimate the rate of inflation for the eighteen-month period using the consumer price index for all urban consumers for nonprescription drugs and the consumer price index for all urban consumers for medical supplies, as published by the United States bureau of labor statistics. The estimated inflation rate is calculated by taking the value of the indexes as of the thirty-first day of December in the fiscal year the rate will be paid, divided by the value of the indexes as of the first day of July in the immediately preceding calendar year. If the estimated inflation rate for the eighteen-month period is different from the actual inflation rate for that period, the difference shall be added to or subtracted from the inflation rate estimated for the following fiscal year.

(D) Franchise permit fee

Notwithstanding the method for reimbursement for other protected costs as set forth in rule 5123-7-12 of the Administrative Code, the franchise permit fee rate in the amount equal to the assessment specified in section 5168.61 of the Revised Code will be included in the other protected costs center per diem rate for each ICFIID subject to the franchise permit fee assessment as specified in section 5168.61 of the Revised Code. The ICFIID will not receive reimbursement for the franchise permit fee if there is no assessment. The franchise permit fee rate is not subject to the inflation factor that is allowed for costs reported in the other protected costs center in accordance with paragraph (C) of this rule.

Replaces: 5123:2-7-23

Notes

Ohio Admin. Code 5123-7-23
Effective: 12/16/2019
Five Year Review (FYR) Dates: 12/16/2024
Promulgated Under: 119.03
Statutory Authority: 5123.04, 5124.03
Rule Amplifies: 5123.04, 5124.03, 5168.61
Prior Effective Dates: 01/10/2013

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